- Sutter Health (Sacramento, CA)
- …joining Sutter Health! **Organization:** SHSO-Sutter Health System Office-Valley **Position Overview:** The Physician Advisor (PA) is a key member of the ... to appropriately optimize the use of Sutter Health Internal Physician Advisor Services (IPAS). The physician...within a managed care environment. + Comprehensive knowledge of Utilization Review , levels of care, and observation… more
- The County of Los Angeles (Los Angeles, CA)
- UTILIZATION REVIEW NURSE SUPERVISOR I Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4924333) Apply UTILIZATION REVIEW NURSE ... information regarding County employee benefits. DHS is seeking dedicated Utilization Review Nurse Supervisors to join our...Medi-Cal reimbursement. + Analyzes cases for referral to the physician advisor to ensure that the admission… more
- The County of Los Angeles (Los Angeles, CA)
- …Organization guidelines and the Joint Commission on Accreditation of Hospitals' utilization review standard. Under the direction of a physician member of the ... UTILIZATION REVIEW NURSE SUPERVISOR II Print...by subordinate supervisors on number and status of reviews, physician advisor referrals, and type of … more
- Alameda Health System (Oakland, CA)
- …placement (eg, inpatient, observation, outpatient). 3. Expeditiously refer cases to the internal/external Physician Advisor for review of requests that may ... System Utilization Management SUM Utilization Review RN + Oakland, CA + Highland General Hospital + SYS Utilization Management + Full Time - Day +… more
- Provider Solutions & Development (Burbank, CA)
- Providence St. Joseph Medical Center is seeking a Physician Advisor /UM Medical Director to join a strong leadership team promoting high-value care in Burbank, ... of medical group management experience required * Must have working knowledge of utilization management and review essential to operations management and to… more
- Sharp HealthCare (San Diego, CA)
- …pre-admission review , utilization management, and concurrent and retrospective review Process. Performs and mentor's physician training of A&G and UM ... selected utilization /cost and quality outcomes. + Participates in policy review , performs analysis and makes recommendations for updating current polices to meet… more
- Sharp HealthCare (San Diego, CA)
- …selected utilization /cost and quality outcomes. + Participates in policy review , performs analysis and makes recommendations. + Participates in the retrospective ... the membership. Serves as a medical manager and policy advisor to SHP and its Chief Medical Officer. Is...to accrediting and regulatory agency feedback. + Supports pre-admission review , utilization management, and concurrent and retrospective… more
- Sharp HealthCare (San Diego, CA)
- …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... medical record and provides information to the department head as indicated. + Utilization review and utilization managementThe RN CM I will:Conduct… more
- Sharp HealthCare (La Mesa, CA)
- …position requires the ability to combine clinical/quality considerations with regulatory/financial/ utilization review demands to assure patients are receiving ... Care Management and provides information to the department head as indicated. + Utilization review and utilization managementThe RN CM will:Conduct initial… more
- Alameda Health System (Oakland, CA)
- …necessarily performed by each individual in the classification. 1. Coordinates all utilization review functions, including response to payor requests for ... guidelines; refers questionable cases to the CM Manager or physician advisor for determination. 3. Takes appropriate...experience in Case Management in an acute setting or utilization review at a medical group or… more